published_or_final_version / Public Health / Master / Master of Public Health

published_or_final_version / Social Work / Master / Master of Social Sciences

published_or_final_version / Nursing Studies / Master / Master of Philosophy

published_or_final_version / Community Medicine / Master / Master of Philosophy

Purpose: Cardiac rehabilitation (CR) programs have been shown to promote numerous health benefits among patients with cardiovascular disease (CVD), but little is known about the characteristics of CR programs. Methods: A survey was developed and utilized to collect data on Early Outpatient Cardiac Rehabilitation programs (EOCR) in the USA. An email with a link to the survey was sent by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) to their members. Program directors/administrators were recruited to provide information about their program in operation during 2009 in the United States. The CR survey contained 13 questions, some with multiple answers, regarding the utilization and patient demographics of an Early Outpatient Cardiac Rehabilitation (Phase II) program. Results: Responses were received from 138 programs in 44 states. Of the responses, 19,689 patients completed at least one EOCR exercise session. Of the responses, 68% of patients were men and 32% of patients were women. Patients enrolled in EOCR programs had a primary diagnosis of CABG 4,803 (30%); AVR/MVR 1,401(9%); MI 3,583 (22%); PCI/Stent 4,961 (31%); stable angina 965 (6%); heart/lung transplant 53 (0.33%); other 385 (2%). 8.4% complete 0-6 sessions of EOCR; 12% complete 7-12 sessions; 22% complete 13-18 sessions; and 58% complete 19-36 sessions. 35% of patients enrolled in EOCR programs are discharged early. 84% of programs offer an outpatient maintenance CR program. 96% of EOCR programs offer education classes; 89% offer resistance equipment; 72% are AACVPR certified; 62% also offer pulmonary rehabilitation; 23% utilize outcome measurements; 62% are in rural locations; and the average patient-to-staff ratio is 4.2:1. Conclusions: CR programs are used by a minority of eligible patients. There is marked variation in the structure and content of EOCR programs. Alternative strategies to improve standardization and outcomes should be implemented. / School of Physical Education, Sport, and Exercise Science

Typescript. / Thesis (Ph. D.)--University of Hawaii at Manoa, 1978. / Bibliography: leaves 214-221. / Microfiche. / ix, 221 leaves, bound 29 cm

The events of cardiac surgery combined with moderate hypothermia hemodilution perfusion and postoperative respiratory care provide the stimuli for the alteration of K+ levels in red blood cells, plasma, and urine. The purpose of this study was to measure the deviations from normal potassium ion concentrations in an attempt to understand the physiological processes involved.

Data were collected from the initial graded exercise tests of 116 cardiac rehabilitation patients. Subjects were grouped according to their blood pressure response to exercise. Blood pressure groupings were typical systolic and typical diastolic (S_TD_T); typical systolic and atypical diastolic ( S_TD_AT); atypical systolic and typical diastolic (S_ATD_T); and both atypical systolic and diastolic blood pressure responses to exercise (S_ATD_AT). Groups were investigated for incidence of atypical responses (decrease, no increase, or excessive increase in systolic pressure and/or excessive increase or high diastolic pressure) and differences in physical characteristics, CVD status, predisposing CHD variables, medications prescribed, peak exercise cardiovascular responses and indicators of myocardial dysfunction. Results revealed atypical blood pressure responses in 65.5% of the subjects. No change in systolic pressure between the last two measured blood pressures was the most frequent atypical response exhibited. The S_ATD_AT pattern group was suggested to be at a higher health risk than the other groups based upon the tendency for higher percentages of subjects in this group exhibiting a history of myocardial infarction (80%), CABG (20%), angina ( 40%) and hypertension (47%). A high percentage of these subjects had been prescribed antihypertensive and antiarrhythmic medications, had "borderline" resting hypertension (X = 135.2/86.3 mmHg) and smoked (61.5%). Peak exercise data revealed a higher heart rate, higher systolic and diastolic pressures, higher RPE, more marked decreases in ECG changes and more supraventricular and ventricular arrhythmias than the other groups. These results based upon observed trends suggest that cardiac rehabilitation subjects with a combination of an atypical systolic and diastolic blood pressure response to exercise may require increased medical supervision during testing, more frequent measurements of blood pressure during testing and consideration of test termination. / M.S.

Made available in DSpace on 2014-06-11T19:25:36Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-08-22Bitstream added on 2014-06-13T19:32:57Z : No. of bitstreams: 1 nunes_gfs_me_botfm.pdf: 1318917 bytes, checksum: a34c3fe0f8fe7a3e6c54514e9f34ed3b (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / As doenças cardiovasculares são atualmente responsáveis por 32% do total de óbitos no Brasil e a hipertensão arterial sistêmica (HAS) é considerada um dos principais fatores de risco. A HAS raramente ocorre de forma isolada e geralmente está associada a outros fatores de risco como a diabetes mellitus, obesidade e o sedentarismo, que são potencialmente modificáveis com a atividade física. A associação dos fatores de risco, sedentarismo e baixo nível de atividade física atuam negativamente na qualidade de vida dos pacientes. Avaliar a associação entre o nível de atividade física e fatores de risco cardiovascular, qualidade de vida e comorbidades dos pacientes do Programa Hiperdia em Agudos. Foram avaliados 200 pacientes hipertensos e diabéticos. Os participantes responderam o Questionário Internacional de Atividade Física, que avalia o nível de atividade física e o SF-36, que avalia a qualidade de vida. Os pacientes foram divididos em quatro grupos conforme a classificação do nível de atividade física (G0: sedentários/GI: irregularmente ativos B/GII: irregularmente ativos A/GIII: ativos). Os grupos foram semelhantes quanto à raça, aspectos sociais, exames físicos, antecedentes de hipertensão, dor, tabagismo e etilismo. Apresentaram diferença estatisticamente significante quanto à idade, sexo, profissão, passado de acidente vascular encefálico, internação por insuficiência cardíaca, diabetes mellitus, adesão aos medicamentos e HDL. Em relação às dimensões da qualidade de vida, os grupos se diferenciaram quanto à capacidade funcional, limitações físicas e estado geral de saúde. Houve associação positiva entre o nível de atividade física e qualidade de vida, mesmo ajustando-se para as variáveis de confusão. O maior nível de atividade física associou-se positivamente a melhor qualidade de vida... / Cardiovascular diseases are currently responsible for 32% of total deaths in Brazil and hypertension (HAS) is considered one of the main risk factors. The HAS rarely occurs in isolation and is usually associated with other risk factors such as diabetes mellitus, obesity and physical inactivity, which are potentially modifiable with physical activity. The association of risk factors, physical inactivity and low level of physical activity act negatively on the quality of life of patients. To evaluate the association between physical activity level and cardiovascular risk factors, quality of life and patient’s comorbidities of Hiper-day Program in Agudos. We evaluated 200 diabetic and hypertensive’s patients. Participants responded to the international physical activity questionnaire, which assesses the level of physical activity and the SF-36, which evaluates the quality of life. The patients were divided into four groups according to the classification of the level of physical activity (G0: sedentary/GI: irregularly active B/GII: irregularly active A /GIII active). The groups were similar regarding race, social aspects, physical exam, high blood pressure in the past, pain, smoking and alcoholism. Showed statistically significant difference as to age, sex, profession, history of stroke, hospitalization for heart failure, diabetes mellitus, adherence to medications and HDL. Related to the dimensions of quality of life, the groups were different with regard to functional capacity, physical limitations and general state of health. There was positivity association between the level of physical activity and quality of life, even adjusting for confounding variables. the highest level of physical activity was associated with the best quality of life, even after excluding the patients... (Complete abstract click electronic access below)

Orientador: Roberto da Silva Franco / Coorientador: Luís Cuadrado Martin / Banca: Roberto Jorge da Silva Franco / Resumo: As doenças cardiovasculares são atualmente responsáveis por 32% do total de óbitos no Brasil e a hipertensão arterial sistêmica (HAS) é considerada um dos principais fatores de risco. A HAS raramente ocorre de forma isolada e geralmente está associada a outros fatores de risco como a diabetes mellitus, obesidade e o sedentarismo, que são potencialmente modificáveis com a atividade física. A associação dos fatores de risco, sedentarismo e baixo nível de atividade física atuam negativamente na qualidade de vida dos pacientes. Avaliar a associação entre o nível de atividade física e fatores de risco cardiovascular, qualidade de vida e comorbidades dos pacientes do Programa Hiperdia em Agudos. Foram avaliados 200 pacientes hipertensos e diabéticos. Os participantes responderam o Questionário Internacional de Atividade Física, que avalia o nível de atividade física e o SF-36, que avalia a qualidade de vida. Os pacientes foram divididos em quatro grupos conforme a classificação do nível de atividade física (G0: sedentários/GI: irregularmente ativos B/GII: irregularmente ativos A/GIII: ativos). Os grupos foram semelhantes quanto à raça, aspectos sociais, exames físicos, antecedentes de hipertensão, dor, tabagismo e etilismo. Apresentaram diferença estatisticamente significante quanto à idade, sexo, profissão, passado de acidente vascular encefálico, internação por insuficiência cardíaca, diabetes mellitus, adesão aos medicamentos e HDL. Em relação às dimensões da qualidade de vida, os grupos se diferenciaram quanto à capacidade funcional, limitações físicas e estado geral de saúde. Houve associação positiva entre o nível de atividade física e qualidade de vida, mesmo ajustando-se para as variáveis de confusão. O maior nível de atividade física associou-se positivamente a melhor qualidade de vida... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Cardiovascular diseases are currently responsible for 32% of total deaths in Brazil and hypertension (HAS) is considered one of the main risk factors. The HAS rarely occurs in isolation and is usually associated with other risk factors such as diabetes mellitus, obesity and physical inactivity, which are potentially modifiable with physical activity. The association of risk factors, physical inactivity and low level of physical activity act negatively on the quality of life of patients. To evaluate the association between physical activity level and cardiovascular risk factors, quality of life and patient's comorbidities of Hiper-day Program in Agudos. We evaluated 200 diabetic and hypertensive's patients. Participants responded to the international physical activity questionnaire, which assesses the level of physical activity and the SF-36, which evaluates the quality of life. The patients were divided into four groups according to the classification of the level of physical activity (G0: sedentary/GI: irregularly active B/GII: irregularly active A /GIII active). The groups were similar regarding race, social aspects, physical exam, high blood pressure in the past, pain, smoking and alcoholism. Showed statistically significant difference as to age, sex, profession, history of stroke, hospitalization for heart failure, diabetes mellitus, adherence to medications and HDL. Related to the dimensions of quality of life, the groups were different with regard to functional capacity, physical limitations and general state of health. There was positivity association between the level of physical activity and quality of life, even adjusting for confounding variables. the highest level of physical activity was associated with the best quality of life, even after excluding the patients... (Complete abstract click electronic access below) / Mestre